STATE-OF-THE-ART PAPER
Noninvasive Imaging in Myocarditis
Hadi N. Skouri, MD*,
G. William Dec, MD, FACC ,
Matthias G. Friedrich, MD, FESC and
Leslie T. Cooper, MD, FACC*,*
* Cardiovascular Department, Mayo Clinic, Rochester, Minnesota
Cardiology Division, Massachusetts General Hospital, Boston, Massachusetts
Stephenson CMR Centre, University of Calgary, Calgary, Alberta, Canada.
Manuscript received March 1, 2006;
revised manuscript received July 5, 2006,
accepted July 5, 2006.
* Reprint requests and correspondence: Dr. Leslie T. Cooper, Jr., Mayo Clinic, 5 Gonda, 200 First Street SW, Rochester, Minnesota 55905. (Email: Cooper.leslie{at}mayo.edu).
Increased recognition of the role of inflammation in acute and chronic dilated cardiomyopathy has revived an interest in noninvasive imaging for detection of myocarditis. Diagnostic strategies that are based on molecular imaging promise to further advance our understanding and improve diagnostic precision. This article reviews the strengths and limitations of common clinical tests used for the diagnosis of myocarditis, with a focus on the emerging role of cardiovascular magnetic resonance imaging. Novel imaging modalities that are currently in preclinical development are discussed with recommendations for future clinical research.
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Abbreviations and Acronyms
| | AM = antimyosin | | AMI = acute myocardial infarction | | CMR = cardiac magnetic resonance | | DCM = dilated cardiomyopathy | | EMB = endomyocardial biopsy | | FM = fulminant myocarditis | | H/L = heart-to-lung ratio | | LE = late enhancement | | LGE = late gadolinium enhancement | | LV = left ventricle/ventricular | | RVSF = right ventricular systolic function | | TD = tissue Doppler | | USPIO = ultrasmall superparamagnetic iron oxide |
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